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November
2
2020

Friday the 30th: Wound Clinic Visit

I went with Dad to his Wound Clinic visit on Friday. I won't go into the gross detail! I promise. We have not forgotten about the wound on his foot  (outside of left foot) that started this whole thing.

It was Oct 30th, so the Wound Clinic staff were dressed up in the theme of Sandlot! it was cute. Nurse Julie was great, she didn't even fire me from driving the wheelchair when I kept ramming it into the door jambs and furniture as we navigated to the treatment room.  

They looked at his wounds on his feet, as well the incisions from his surgeries to make sure they are healing well. They took pictures and measurements (and let Dad relax with a warm blanket and a cover over his eyes, so he was pretty cozy). Mandy ,the provider, came in to assess his wounds.  Then they talked with Dad about how things are looking and what the plan is next.

He will still need  part/some of his foot amputated. We have a referral for an orthopedic surgeon that specializes in feet and we hope to have an appointment this week or early next week for assessment and to make a plan.  He is currently non weight bearing on his left foot, except for quick transfers from bed to chair etc. because they don't want pressure on his wound.

So that is the update on his foot. He is doing well overall, considering he had a stroke a little over a week ago. I think Mom is going to write an update sometime today. 

If you want, leave a Well Wish for Ken/Dad. I think when he is ready, he will love to hear them and hear from you guys. 

Thanks again for your love and support. 

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October
30
2020

What is Expressive Aphasia?

The biggest issue that Dad is having right now is word finding, also called Expressive Aphasia. A co-worker explained it to me like this: Imagine a secretary, pulling files out of a filing cabinet. Left and right, pulling all the right files when they are needed. Now, imagine that secretary loses the use of her arm, and still need to pull files. It will be slower, it will take more time, and the wrong file gets pulled sometimes. The amount of aphasia varies based on the type and severity of the stroke.

Dad has a hard time with finding the right word at the right time. He knows its wrong, but has a hard time pulling the right word from his memory bank. He might have difficulty forming complete sentences, has trouble following left right under after directions, uses a word that is close to what he wants, but not the right word. An example of this, he was talking to Margaret and said "Hi Elizabeth" but knew it was wrong. He said, no no no,you are married to Ben Bailey, but couldn't retrieve the word "Margaret". He also might say Yes, but mean No and vice versa, or say the wrong pronoun.  

He understands what is being said, his comprehension, reading and listening are probably not as affected has his speech right now. BUT his intelligence is not affected. 

Things to do to help:
  • Keep it simple
  • Be Patient, talk with him, not for him. Allow plenty of time for a response. 
  • Remove distractions (T.V., phone calls on speaker, etc.)
  • Be Creative: use gestures, pictures, drawing etc. 
  • Confirm: repeat back what you think he is saying
  • Speak to him directly
  • Ask dad if he wants help expressing what he wants to say. 
  • Take Breaks! Fatigue is such a real part of life post stroke, things that wouldn't tired Dad out before, will now. He needs lots of rest to help his brain get better.
I was texting with my friend that is a speech therapist (holla KHS) last night and this is a snippet of our conversation:

Me: Aphasia, will it get better? I might need a video of you telling my family it will be better, lol. 

Rockstar Speech Therapist: Yes yes yes. It will get better. He's going to do great....slow and steady progress is pretty typical with aphasia. He just needs time and consistency and so much brain rest. Just think about how many transitions he's been through in the last week.  He's in good hands now!

Me: Totally! He is so so tired.

Rockstar Speech Therapist: The next few weeks will be good. He's going to settle into recovery and rehab mode. I have a guy I have working with for a year who was inpatient and he's come SO far and still is making progress. 

So--it will is a long road, but the road is walk-able and run-able and passable and we it will take it one day at a time. 


Other resources on the web:
https://www.aphasia.org/aphasia-resources/communication-tips/
https://www.aphasia.org/aphasia-faqs/
https://www.stroke.org/en/about-stroke/effects-of-stroke/cognitive-and-communication-effects-of-stroke/types-of-aphasia

October
30
2020

Rehab Here We Come..

Tuesday, Oct 27th continued....and some of Wed etc.

Mom came around 11 am for our "shift change" ---because Dad could only have 1 visitor at a time, I was going to start the day, Mom would come in the middle, and Kathryn would bring up the end of the day after work. I headed down to the parking garage to head to work. By the time I got to my car, she called to let me know they were hoping to transfer him to the rehab hospital by 3:30 that day (yay!) This means he would be able to get more sleep, get the rehab he needs to help recover from the stroke, and have medical management of his wound/foot (we still haven't forgotten about the foot!). 

Mom stayed with Dad, I cruised out to their house and packed a suitcase for Dad (with some Facetime help from Kathryn, high five for teamwork) complete with his pillow and a cozy blanket to make his room more homey. Kathryn and I were facetiming with Mom when the hospitalist came in to discuss his status and transfer to rehab. 

I took his stuff to my office to prepare to welcome him to the rehab hospital. Surprise. I work there. I work on the outpatient side, but am familiar with inpatient rehab and know a lot of people that will work with Dad during his stay.  I *might* have put in a request for him to be in room 218 or 219.  My office is about...50 paces away from his room.  I took a Marco Polo to show the family how close we were. 

Dad got transferred around 3:30, Mom was able to come up to his room about 4:00. The rehab hospital has a stricter visitor policy, with only 1 visitor allowed from 4pm to 7pm. No visitors during the day, unless they are doing family training on specific aspects of rehab. 

Because of how close I am to his room, and because I am "an employee" with a "badge" I have been able to check in on Dad throughout the day. He gets at least 3 hours of rehab a day (PT, OT, ST), and  seen by wound care,  internal medicine, and other specialists,  and at some point has to eat and rest. 

By the end of the day, he is exhausted and definitely is ready for some rest.  

We are hoping that updating here will limit some of the phone calls to Mom, and especially to Dad, so he can rest. We have heard "make sure he limits screen time" more than once! 

Thanks to everyone that has reached out and asked how to help and support us at this time. Your love and kindness means the world. 

October
30
2020

Bringing Everyone Up to Speed: Part Two

Monday and Tuesday, October 26-27

Ken spent Monday and Tuesday in the "acute" hospital, getting assessed. Blood was drawn, specialists conferred, a few naps were taken, more blood was drawn.  I (Liz) was there for one of the blood draws and the lab tech brought out the "vials" and there were a few regular vials but.... You know those "airplane" liquor bottles? She had one for each arm. This is not a lie. Or an exaggeration. Plus more vials. and then some more stuff.
See attached picture...

I learned that Dad did not have trouble finding his favorite curse word during that blood draw (win!). 

He was also assessed by Occupational Therapy (OT), Physical Therapy (PT), and Speech Therapy (PT) on Monday. All recommended that it would be good for Ken to go to a rehab hospital for recovery from his stroke.  A Rehab Hospital is dedicated to helping patients recovery from neurological incidents like strokes and brain injuries, as well as orthopedic surgeries (Hi Karla and Lois!) and other concerns when people can't discharge straight from acute care to home. 

I spent Tuesday morning with Dad. I watched him eat breakfast, chatted a little about his night, and then his speech therapist came in to do more assessments. Speech therapy likes to watch stroke patients eat to ensure they aren't having issues with swallow. Speech therapists treat pretty much everything from the throat up...they treat swallows, speech, cognition, and various other diagnoses. 
The want to make sure that he is swallowing well, to ensure he doesn't aspirate food or liquid into his lungs, which could lead to pneumonia. 

Read on for the exciting conclusion to Tuesday! We got some great news.....
October
30
2020

Bringing Everyone Up to Speed: Part One

Hello
We wanted to provide a spot for family and friends to come to get updates on Dad and how things are going since his stroke. Everyone is being so kind and reaching out, which just shows how loved Ken is. This will help keep everything in one spot, help you stay updated, and help unburden Mary Lue from updating everyone separately. It is hard to keep track of what we have told to whom, so we think this will help! 

Ken suffered a stroke on Saturday, October 24th. The week leading up to his stroke, he was in West Valley hospital in Caldwell, getting some assessments done on a wound on his left foot. After a week of assessments, IV antibiotics, and a few complications he was discharged on Saturday the 24th. We think he had his stroke sometime on Saturday or Sunday, His motor skills were not affected (he could walk, talk, move both arms, smile was normal, no droopy face), so it was hard to pinpoint when it happened.

Ken had a stroke in 2018, and at that time it resolved very quickly with just a few residual issues with word finding and some short term memory issues. On Saturday the 24th when he came home, he was very very tired and had some word finding issues, which we attributed to a combination of exhaustion from getting little to no sleep in the hospital, and the pain medication he was on. Fatigue is a long lasting friend (and sometimes unwelcome!) with stroke survivors, and we have seen this during the last 2 years. When his fatigue increases, his word finding tanks. 

On Sunday the 25th in the afternoon, Mary Lue took Ken to the Emergency Room at St. Luke's in Meridian. After a battery of blood tests, a CT and an MRI, it was determined that Ken suffered a new stroke in a new part of this brain. This time in the left lateral mid frontal lobe.   Translation: front part of his brain on the left side, which plays a large part in language. 

Shortly after midnight, they transferred Ken from Meridian to St. Luke's in Boise (about 10 miles away). Boise has a number of specialists in regards to stroke. Due to Covid, there are visitor restrictions in place, with only 1 visitor at a time per patient.  Elizabeth met Ken at the hospital after his transfer, helped him get settled, and stayed with him for a few hours to make sure he was comfortable. 

 Stay Tuned for Part Two!